Hiv and herpes simplex virus 2 incidence among adolescent girls and young women who sell sex (YWSS) in rural south africa: a population-based cohort study.
Faith Magut, Lusanda Mazibuko, Nondumiso Mthiyane, Guy Harling, Kathy Baisley, Thembelihle Zuma, Jaco Dreyer, Nonhlanhla Okesola, Osee Behuhuma, Carina Herbst, Theresa Smit, Janet Seeley, Sian Floyd, Isolde Birdthistle, Frances Cowan, James R Hargreaves, Natsayi Chimbindi, Maryam Shahmanesh
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引用次数: 0
Abstract
Objective: We investigate the risk of acquiring HIV or HSV-2 among young women who sell sex (YWSS) in rural South Africa.
Design: A representative population-based prospective cohort study of adolescent girls and young women (AGYW).
Methods: Between 2017 and 2019 we interviewed a random sample of AGYW (13-30 years) annually and collected dried blood spot samples for HIV and HSV-2 serology. YWSS were defined as engaging in transactional sex and/or sex work in the past 12 months. We used Cox regression to estimate the association between selling sex and incident HIV or HSV-2 infections, using inverse probability weighting to adjust for potential confounding (age, education, rural/urban locality, socioeconomic status, food insecurity, and pregnancy status).
Results: Among eligible AGYW (n = 3846), 89.2% provided responses for at least one follow-up time-point, of whom 17% reported selling sex in the past 12 months. HIV and HSV-2 prevalence at enrolment were 21% and 37.9% respectively and higher among YWSS at 42% and 69% respectively. HIV incidence was 3.4/100 person years(py) (95%CI: 2.6-4.2) higher among YWSS than others (8.2 vs 2.7/100py; Hazard Ratio [HR]: 2.70; 95%CI: 1.83-3.99). HSV-2 incidence was 18.4/100py (95%CI: 16.5-20.5), and was higher among YWSS than others (29.3 vs 17.2 100py; HR: 1.83; 95%CI 1.41-2.39). HSV-2 at baseline was associated with subsequent HIV infection (HR: 6.32; 95%CI 3.86-10.47, p<0.001).
Conclusion: HIV and HSV-2 incidence was higher among AGYW selling sex compared those who did not sell sex. These findings highlight the need for PrEP and socio-economic support for this priority population of AGYW in rural settings.
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Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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